Sunday, 25 February 2007

The Amazing Race 11 (All-Star Edition), Episode 2

I had hoped that the All-Star Edition of The Amazing Race , with a cast selected from participants in previous seasons of the reality-television show, would provide useful lessons about how people learn from the experience of travel, and do things differently the second time they travel around the world.

Thus far, reality has disappointed, as the teams (and the producers who plan the route and activities, although I'll leave that for another week) have repeated some of the classic mistakes that were made by first-time world travellers in previous seasons.

This week's episode, for example, was not the first time that altitude sickness was the main factor in the results of an episode of the race, as I discussed when it happened at 2500 meters (8000 feet) in Ethiopia in season 6.

This time, there probably wasn't anything Drew and Kevin could have done to avoid falling behind and being eliminated. Some people are more susceptible to altitude sickness, or generally feel its effects at lower altitudes. Even people who've had no problems on previous ascents to a given altitude may suddenly experience serious symptoms at the same altitude on a later trip. And perhaps most importantly, serious altitude sickness isn't something you can, or should, simply "be tough" and suffer through. If you need medical treatment for altitude sickness, you should probably go down to a lower altitude at the first opportunity to do so.

If your symptoms are mild, you can rest, go no higher, and hope to acclimatize over several days. That won't help you win any races (not that you're likely to win any races while out of breath from the altitude), but your life is worth more than a million dollars. The potential need for time to acclimatize -- somewhat unpredictable, regardless of your physical fitness or prior experience with high altitudes -- is a strong reason to not to plan a rushed schedule.

If you have a tour or an onward flight already booked, you may be tempted to ignore the warning signs of altitude sickness. Don't. More severe symptoms can become life-threatening quickly, and you aren't likely to enjoy anyway if you continue your planned high-altitude itinerary. Here's how Drew described it in an interview with BuddyTV , which is publishing interviews with each eliminated team this season:

Altitude sickness, if you've ever had it, it's really bad. I don't know how to compare it to sea sickness because I've never had that but let me tell you, you get a headache that feels like your head is in a vice and someone's just squeezing the vice; slowly and surely squeezing it. I was vomiting all night and after I was done vomiting I had the dry heaves all night. I had to sleep on the floor, which many of us did, but I was furthest away from the fireplace so I had the chills and they had to give me oxygen all night. It was pretty bad.

The biggest factor in the severity of Drew's symptoms was the altitude -- 3,550 meters (11,500 feet) -- at which they spent the night on the slope of Cotopaxi. A day trip to a higher altitude from a lower altitude where you sleep is much less likely to produce severe altitude sickness than sleeping high. And it's usually much easier to turn around and descend if you get ill on a day trip than if you have already flown to a high-altitude base. The racers flew to 2500 meters (8200 feet) at Calama, and immediately started driving up from there to the Chuquicamata copper mine at 2850 meters (9350 feet).

It's quite typical of the real world that Kevin and Drew didn't realize that they should have gone down to a lower altitude (or stayed at a lower altitude once they had descended to sea level to change planes in Lima), and that they didn't realize that they were in no condition to be driving.

People whose mental functioning is impaired by altitude sickness frequently need to have their condition pointed out by those around them, and sometimes need to be forced by their companions to descend, against their impaired judgement that they are able to go on.

Perhaps the television production crew included doctors who were able to give confident advice that the racers were in no danger, physically fit to go back up to the Atacama desert and mentally fit to operate motor vehicles. But real travelers don't have doctors in attendance. If you are in severe pain from altitude, or people tell you that you are "acting stupid" or abnormally clumsy, trust their judgement ahead of your own.

Driving while light-headed, confused, and with reactions slowed by altitude sickness can easily be as dangerous, to yourself and others, as driving while falling-down drunk. Stop right away, and get to a lower altitude as soon as possible. Reactions to altitude vary from person to person, so if you have to drive to get down, have the person least affected by the altitude do the driving. Mountain roads often get narrower as they climb, with fewer places to turn around. So stop and think, before you continue past a turnaround point, whether you are confident you'll be able to turn back if either the condition of the road or the condition of your body and mind gets worse farther up the road.

Don't get overly worried. If you plan your itinerary with adequate time to reach higher altitudes slowly and to acclimatize, pay attention to the symptoms of altitude sickness, and descend if they are serious, increasing, or prolonged, your problems should be limited to moderate discomfort. But unless you too have doctors and a support team prepared to intervene and evacuate you if things go wrong, don't follow the example that the racers set this week.

In late October 2006, I spent a week in Ecuador--of course, flying into Quito.

We arrived around 7 p.m. and were at the hotel within 30 minutes or so.

Walking around the airport left me much more winded than usual, and that was ok as far as I was concerned (if that was to be the extent of the altitude's effects).

Maybe 2 hours after arriving, we were to eat dinner at the hotel, and all I could do was drink water. I ate some soup but couldn't really bear to eat much. Drink water, more water.

At most an hour after dinner, we were back up in our room and I took a shower to wash the day of travel off. As soon as I got out of the shower, everything started spinning. If I held the wall, things were a little better but still very uncomfortable. I'm prone to motion sickness as well, and this point, it was on par with bad motion sickness (minus vomiting).

That night I was unable to get comfortable and I think I only slept an hour or so. My girlfriend went to the lobby to request some mate de coca (coca leaf tea), which she'd had in Peru years earlier and is a natural treatment for altitude sickness. They said the tea was prohibited and sent up a glass full of honey and some apple-flavored tea. The prescription: take a sip of tea followed by a spoonful of honey, repeat until the honey is gone.

The sugar from the honey may have helped a little, but overall this was a poor treatment for altitude sickness.

The next morning, I ate a tiny breakfast--some fruit, juice, water, maybe a pastry. Our group was to be driving high up into Cotopaxi that day and I was concerned about the altitude. However, by the time breakfast was finished, I felt a lot better than I did upon waking.

We spent the next few nights at lower altitude haciendas, with our last night before leaving, back in Quito.

Sure enough, early in the morning, I woke up, spinning again, very nauseous. To the bathroom, I stumbled and vomited a few times. Not nice. And then the diarrhea. Because of the latter, I suspect this was from some food the night before. Still, we had to buy individual tablets of Imodium to block my bowels up enough to the day of travel to come.

That last day, I also had some mate de coca that we bought in Cuenca at a museum. Three cups of it made me more aware and maybe a bit jittery but didn't seem to do much to air my condition.

I've since heard that some people are using Viagra to help deal with high altitudes. No idea how precisely it's being used, but worth researching more, I guess.

"Congress shall make no law ... abridging ... the right of the people peaceably to assemble." (U.S. Constitution)

"Everyone has the right to freedom of movement and residence within the borders of each state. Everyone has the right to leave any country, including his own, and to return to his country." (Universal Declaration of Human Rights)

"Liberty of movement is an indispensable condition for the free development of a person." (United Nations Human Rights Committee)